Human error was the main cause of the mix-up in which the dead body of a 90-year-old man was mistakenly claimed and cremated by the family of another deceased person, an independent committee reviewing the incident has concluded.

Releasing its investigation report today, convenor Wan chi-keung said the committee found the two mortuary staff concerned had not followed established identification procedures before releasing the body to the first family.

"This was followed by their attempt to cover up the incident by moving the other dead body to another rack and removing the identification wristband," he said.

Mortuary matters: Committee convenor Wan Chi-keung (left) gave an account on the probe findings, while Director of Health Dr PY Lam and Forensic Pathology Consultant Dr KL Hau pledged to improve mortuary service.

Mr Wan said when the second family arrived to claim the body, a third mortuary staff did not follow the identification guidelines before releasing the wrong body.

However, Mr Wan said there is in place a clear set of operational guidelines in respect of the receipt, identification and release of dead bodies in public mortuaries.

Suggested improvements

In their report, the committee has recommended a package of short-term improvement measures in the following areas:

*Staffing and training - adding clerical staff to handle documentation works, strengthening training and supervision of mortuary staff, reviewing staff duty rosters, and stepping up internal audits with surprise checks;

*Dead body identification procedures - adding fingerprint and photos in the identification process, soliciting Police help to put wristbands on bodies and strengthening public education on the procedures;

*Mortuary and funeral facilities - reforming the storage-numbering system, banning unauthorised entry to restricted areas, expanding the CCTV system's coverage, offering counselling service to family members and providing facilities for a simple, dignified ceremony.

In the long run, the committee recommends deploying customer service officers at mortuaries and establishing a professional management framework for mortuaries.

Accepting the findings and recommendations, Director of Health Dr P Y Lam said all the recommended measures would be implemented to prevent future incidents, adding short-term measures are already in place to improve public mortuaries' operation.

He added medical staff have been reminded to step up supervision and monitoring of procedures' compliance.

All public mortuaries staff have also been briefed again on the procedures and reminded to exercise due care in double-checking the identity of every dead body before handing them over to the families concerned.

Relatives will be asked to view the bodies and check the particulars on the identification bracelets before collecting them.

Dr Lam said disciplinary action is being considered against the two mortuary staff involved in the first body claim. Copies of the report will be sent to the Department of Justice and the Police for their advice on whether criminal elements are involved.

Regarding the third staff, he said the case is being examined to see whether there is sufficient evidence to initiate disciplinary action.

Dr Lam again offered his apology to the two affected families, adding he fully understood their sorrow and the inconveniences the incident caused them.